<!--content-->
<div class="bh-content">
	<div class="bh-ly-jj-lyorder_con bh-padT10">
		<?php echo $this->renderPartial('application.views.partials.order.schedule');?>
    	<div class="bh-ly-jj-lyorder bh-Border_1 bh-mtop15">
    		<?php $form = $this->beginWidget('lib.widgets.CActiveFormAdv')?>
    		<?php echo $form->hiddenField($model,'items.related_id')?>
    		<?php echo $form->hiddenField($model,'items.goods_id')?>
    		<?php echo $form->hiddenField($model,'items.provider_id')?>
    		<?php echo $form->hiddenField($model,'items.dealer_id')?>
    		<?php echo $form->hiddenField($model,'items.item_price')?>
        	<table width="100%" border="0" cellspacing="0" cellpadding="0">
              <tr height="40">
                <td class="bh-textRt">预订线路：</td>
                <td><?php echo CHtml::value($model, 'items.goods.fulltitle')?></td>
              </tr>
              <tr height="40">
                <td class="bh-textRt"><?php echo $form->labelEx($model,'profile.departure_date')?>：</td>
                <td>
                	<?php $this->widget('lib.widgets.my97date.CMy97DatePicker', array(
			 			'model' => $model,
			 			'attribute' => 'profile.departure_date',
                		'htmlOptions' => array(
                			'class' => 'bh-ly-jj-lvyouOrder_text bh-mlt16'
                		)
					));?>
                	
					<?php echo $form->error($model, 'profile.departure_date')?>
                </td>
              </tr>
              <tr height="40">
                <td class="bh-textRt"><?php echo $form->labelEx($model,'items.item_num')?>：</td>
                <td>
                <?php echo $form->textField($model, 'items.item_num',array(
					'class'=>'bh-ly-jj-lvyouOrder_text bh-mlt16',
				))?>
				<?php echo $form->error($model, 'items.item_num');?>
              </tr>
              <tr height="35" class="bh-ly-jj-borderB1">
                <td></td>
                <td></td>
              </tr>
              <tr height="15">
                <td></td>
                <td></td>
              </tr>
              <tr height="40">
                <td class="bh-textRt"><?php echo $form->labelEx($model,'receiverInfo.receiver')?>：</td>
                <td>
                	<?php echo $form->textField($model,'receiverInfo.receiver',array(
						'class'=>'bh-ly-jj-lvyouOrder_text border_tonyi',
					))?>
					<?php echo $form->error($model, 'receiverInfo.receiver')?>
                </td>
              </tr>
              <tr height="40">
                <td class="bh-textRt"><?php echo $form->labelEx($model,'receiverInfo.mobile')?>：</td>
                <td>
                	<?php echo $form->textField($model,'receiverInfo.mobile',array(
						'class'=>'bh-ly-jj-lvyouOrder_text border_tonyi',
					))?>
					<?php echo $form->error($model, 'receiverInfo.mobile')?>
                </td>
              </tr>
              <tr height="40">
                <td class="bh-textRt"><?php echo $form->labelEx($model,'receiverInfo.email')?>：</td>
                <td>
                	<?php echo $form->textField($model,'receiverInfo.email',array(
						'class'=>'bh-ly-jj-lvyouOrder_text border_tonyi',
					))?>
					<?php echo $form->error($model, 'receiverInfo.email')?>
                </td>
              </tr>
              <tr height="100">
                <td class="bh-textRt" valign="top">备注：</td>
                <td>
                	<?php echo $form->textArea($model,'remark',array(
						'class'=>'bh-ly-jj-text-area1 border_tonyi',
					))?>
					<?php echo $form->error($model, 'remark')?>
                </td>
              </tr>
              <tr height="40">
                <td></td>
                <td>
                    <div class="bh-ly-jj-agree_RA">
                    	<?php echo CHtml::radioButtonList('agree', '1', array('1'=>'我同意','2'=>'我不同意'),array('separator'=>''));?>
                    </div>
                
                </td>
              </tr>
              <tr height="15">
                <td></td>
                <td></td>
              </tr>
              <tr>
                <td></td>
                <td>
                    <textarea class="bh-ly-jj-lyOrder_tiaokuan  border_tonyi">1、本投保人兹申明以上述各项内容填写属实。 
            本投保人已认真阅读并正确理解《平安旅行意外伤害保险条款》各项内容，尤其是有关免除责任的条款。本投保人已经完全获知并认同保险条款、免责、理赔须知等具体内容，并同意接受条款全部内容。
            
             2、根据《中华人民共和国合同法》第十一条规定，数据电文是合法的合同表现形式。本人接受以平安养老保险股份有限公司提供的电子保单作为本投保书成立的合法有效凭证，具有完全证据效力。
            
             3、本人同意提供给平安集团（指中国平安保险（集团）股份有限公司及其直接或间接控股的公司）的信息
            </textarea>    
                </td>
              </tr>
              <?php $this->endWidget()?>
            </table>
			<div class="bh-ly-jj-lyordersuball">
				<?php echo CHtml::submitButton('确定',array(
					'class'=>'bh-ly-jj-lyordersub bh-strong bh-noborder',
					'name'=>'lyordersub',
				));?>
				&nbsp;&nbsp;
				<?php echo CHtml::resetButton('取消',array(
					'class'=>'bh-ly-jj-lyordersub bh-strong bh-noborder bh-href',
					'name'=>'lyordersub',
					'href' => Yii::app()->request->urlReferrer
				));?>
			</div>
			<div class="bh-space"></div>
        </div>
    </div>
</div>
<div class="bh-space"></div>
<!--content-->
